|
|
| (10 intermediate revisions by 2 users not shown) |
| Line 1: |
Line 1: |
| __NOTOC__ | | __NOTOC__ |
| {{SI}} | | '''For patient information click [[{{PAGENAME}} (patient information)|here]]''' |
|
| |
|
| '''For patient information page click [[{{PAGENAME}} (patient information)|here]]'''
| | {{Template:Oliguria}} |
|
| |
|
| {{CMG}} | | {{CMG}} |
| | <br><br>'''To view a comprehensive algorithm of common findings of urine composition and urine output, click [[Urine#Algorithm of Common Urinary Findings|here]]'''<br> |
| | ==[[Oliguria overview|Overview]]== |
|
| |
|
| {{SK}} Decreased urine output; reduced urine output
| | ==[[Oliguria historical perspective|Historical Perspective]]== |
| ==Overview== | |
| '''Oliguria''' and '''anuria''' are the decreased or absent production of [[urine]], respectively.
| |
|
| |
|
| Oliguria is defined as a urine output that is less than 1 mL/kg/h in infants, less than 0.5 mL/kg/h in children, and less than 400 mL/day (equals 17mL/hour) in adults.<ref>{{cite journal | author = Klahr S, Miller S | title = Acute oliguria. | journal = N Engl J Med | volume = 338 | issue = 10 | pages = 671-5 | year = 1998 | id = PMID 9486997}} [http://content.nejm.org/cgi/content/full/338/10/671 Free Full Text].</ref>
| | ==[[Oliguria classification|Classification]]== |
|
| |
|
| ==Causes== | | ==[[Oliguria pathophysiology|Pathophysiology]]== |
|
| |
|
| ===Common Causes=== | | ==[[Oliguria causes|Causes]]== |
| *List the most common causes here.
| |
| ===Causes by Organ System===
| |
| {|style="width:82%; height:100px" border="1"
| |
| |style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
| |
| |style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Chemical/Poisoning'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Dental'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Dermatologic'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Drug Side Effect'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Ear Nose Throat'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Endocrine'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Environmental'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Gastroenterologic'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Genetic'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Hematologic'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Iatrogenic'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Infectious Disease'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Musculoskeletal/Orthopedic'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Neurologic'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Nutritional/Metabolic'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Obstetric/Gynecologic'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Oncologic'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Ophthalmologic'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Overdose/Toxicity'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Psychiatric'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Pulmonary'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Renal/Electrolyte'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Rheumatology/Immunology/Allergy'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Sexual'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Trauma'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Urologic'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Miscellaneous'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |}
| |
|
| |
|
| ===Causes in Alphabetical Order=== | | ==[[Oliguria differential diagnosis|Differentiating Oliguria from other Diseases]]== |
| {{col-begin|width=85%}}
| |
| {{col-break|width=33%}}
| |
| *[[Disease]] A
| |
| *[[Disease]] B
| |
| *[[Disease]] C
| |
| *[[Disease]] ...
| |
| {{col-break|width=33%}}
| |
| *[[Disease]] P
| |
| *[[Disease]] Q
| |
| *[[Disease]] R
| |
| *[[Disease]] ...
| |
| {{col-break|width=33%}}
| |
| *[[Disease]] X
| |
| *[[Disease]] Y
| |
| *[[Disease]] Z
| |
| {{col-end}}
| |
|
| |
|
| | ==[[Oliguria epidemiology and demographics|Epidemiology and Demographics]]== |
|
| |
|
| | ==[[Oliguria risk factors|Risk Factors]]== |
|
| |
|
| The mechanisms causing oliguria can be divided into several categories:
| | ==[[Oliguria natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
| | |
| ===Prerenal=== | |
| In response to [[hypoperfusion]] of the kidney (e.g. as a result of [[dehydration]] by poor oral intake, [[diarrhea]], massive [[bleeding]] or [[sepsis]])
| |
| | |
| ===Renal===
| |
| Due to kidney damage (severe [[hypoperfusion]], [[rhabdomyolysis]], [[medication]])
| |
| | |
| ===Postrenal===
| |
| As a consequence of obstruction of the urine flow (e.g. [[enlarged prostate]], tumor compression urinary outflow, expanding [[hematoma]] or fluid collection)
| |
| | |
| The decreased production of urine may be a sign of [[dehydration]], [[renal failure]] or [[urinary obstruction]]/[[urinary retention]].
| |
| | |
| ===Postoperative Oliguria===
| |
| Patients usually have a decrease in urine output after a major operation that may be a normal physiological response to:
| |
| * Fluid/blood loss – decreased glomerular filtration rate secondary to [[hypovolemia]] and/or [[hypotension]]
| |
| * Response of adrenal cortex to stress -increase in [[aldosterone]] (Na and water retention) and [[antidiuretic hormone]] (ADH) release
| |
| | |
| ===Oliguria in Infants===
| |
| Oliguria, when defined as less than 1 mL/kg/h, in [[infant]]s is not considered to be a reliable sign of renal failure.<ref>{{cite journal | author = Arant B | title = Postnatal development of renal function during the first year of life. | journal = Pediatr Nephrol | volume = 1 | issue = 3 | pages = 308-13 | year = 1987 | id = PMID 3153294}}</ref>==Risk Factors==
| |
| Patients having any of the conditions mentioned in the causes are at risk of oliguria.
| |
| | |
| ==Natural History, Complications and Prognosis==
| |
| Although a significant decrease in urine output may indicate a serious, even life-threatening condition, adequate urine output can be restored with prompt medical treatment.
| |
|
| |
|
| ==Diagnosis== | | ==Diagnosis== |
| ===History and Symptoms===
| | [[Oliguria history and symptoms| History and Symptoms]] | [[Oliguria physical examination | Physical Examination]] | [[Oliguria laboratory findings|Laboratory Findings]] | [[Oliguria CT|CT]] | [[Oliguria other imaging findings|Other Imaging Findings]] | [[Oliguria other diagnostic studies|Other Diagnostic Studies]] |
| History of
| |
| * Time pattern
| |
| **When did this begin?
| |
| **Did it occur suddenly?
| |
| **Has it rapidly become worse?
| |
| * Quality
| |
| **How much does the patient drink each day?
| |
| **Does drinking more increase the daily urine output?
| |
| **How much urine does the patient produce each day?
| |
| **What color is the [[urine]]?
| |
| * Aggravating factors
| |
| **Has there been fever?
| |
| **Has there been [[diarrhea]]?
| |
| **Has there been [[vomiting]]? With or without [[nausea]]?
| |
| **Is thirst decreased?
| |
| **What other symptoms does the patient have?
| |
| * Other
| |
| **What medications does the patient take?
| |
| **Does the patient have any [[allergies]]?
| |
| **Does the patient have access to adequate fluids?
| |
| * Medical history
| |
| **Has the patient had any recent injuries such as [[burns]]?
| |
| **Has the patient been sick?
| |
| **Does the patient have a history of a problem with the [[kidney]]s or [[bladder]]?
| |
| | |
| ===Laboratory Findings===
| |
| * Blood studies to monitor [[electrolyte]]s and kidney function.
| |
| * Urine tests, including tests for [[infection]].
| |
|
| |
|
| ==Treatment== | | ==Treatment== |
| ===Medical Therapy===
| | [[Oliguria medical therapy|Medical Therapy]] | [[Oliguria surgery|Surgery]] | [[Oliguria primary prevention|Primary Prevention]] | [[Oliguria secondary prevention|Secondary Prevention]] | [[Oliguria cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Oliguria future or investigational therapies|Future or Investigational Therapies]] |
| It mainly depends on the cause:
| |
| ====Home Care====
| |
| The patient should follow prescribed fluid regimens and measure urine output as directed.
| |
|
| |
|
| ===Primary Prevention=== | | ==Case Studies== |
| Prevention depends on the underlying cause.
| | [[Oliguria case study one|Case#1]] |
|
| |
|
| ==References==
| | {{WikiDoc Help Menu}} |
| {{reflist|2}} | | {{WikiDoc Sources}} |
| | |
| [[de:Oligurie]]
| |
| [[es:Oliguria]]
| |
| [[fr:Oligurie]]
| |
| [[it:Oliguria]]
| |
| [[ja:乏尿]]
| |
| [[pt:Oligúria]]
| |
| [[sk:Anúria]]
| |
| [[sl:Oligurija]]
| |
| [[zh:寡尿]]
| |
|
| |
|
|
| |
| [[Category:Signs and symptoms]]
| |
| [[Category:Nephrology]] | | [[Category:Nephrology]] |
| [[Category:Cardiology]] | | [[Category:Cardiology]] |
| Line 236: |
Line 41: |
| [[Category:Emergency medicine]] | | [[Category:Emergency medicine]] |
| [[Category:Urology]] | | [[Category:Urology]] |
|
| |
| [[pl:Skąpomocz]]
| |
| {{WikiDoc Help Menu}}
| |
| {{WikiDoc Sources}}
| |